Despite concern in recent literature about the adverse effects and complications of metal-on-metal total hip replacements, we have obtained excellent results ten to 15 years after metal-on-metal total hip arthroplasty in 11 out of 12 patients (91.66%) that were available for clinical follow-up. We could trace 15 out of a total of 18 patients (88.33%). Three patients died between the nine- and ten-year follow-up. All our available patients were clinically examined using the Harris Hip Score; hip radiographs; ultrasound and blood investigations. Only one patient (8.33%) needed revision surgery. This information can be used to reassure both orthopaedic surgeons and patients who had metal-on-metal total hip arthroplasty performed in the past that not all metal-on-metal total hip replacements need to be revised. We would advise that if patients present with symptoms or signs they should be thoroughly examined clinically and radiologically, and undergo laboratory investigations, before considering revision surgery.